Prevalence of Allergic Diseases and Atopy in Subjects With Coronary Artery Disease

NCT ID: NCT01552161

Last Updated: 2014-01-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2010-04-30

Study Completion Date

2012-06-30

Brief Summary

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The purpose of this study is to estimate the prevalence of allergic diseases and atopy among patients with angiographically confirmed coronary artery disease as well as to assess levels of serum allergic inflammation markers in this population.

Detailed Description

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Cardiovascular disease (CVD) is one of the leading causes of death, disability and medical resources use worldwide. Atherosclerosis remains the basic pathology found in CVD. Based on theoretical knowledge and animal experimental models it can be hypothesized that allergic inflammation affects atherosclerotic plaque formation/disruption. The exact nature of such interaction remains unknown.

The process most probably takes place at the molecular level and involves both: specific interleukin formation and mast cells recruitment. On the one hand some pro-allergic interleukins have been found to inhibit atherosclerotic plaque formation in experimental animal models. However, other hypothesis conclude that mediators released by mast cells might encourage hypoxemia of the heart muscle cells and thus promote their necrosis. Mast cells and eosinophils -typically associated with allergy - are both found in human heart muscle, cross sections of coronary arteries and atherosclerotic plaques.

Atopic patients who are prone to IgE-mediated mast cell activation seem to run a lower risk of sudden cardiac death after myocardial infarction. It may be associated with the fact that atopy produces a mild haemostatic imbalance similar to that typical of aspirin - moderately long bleeding time, depressed platelet aggregability and delayed generation of thrombin in clotting blood. Tryptase, one of the mediators released from mast cells widely used marker of anaphylaxis, has recently been shown to be increased in sera of patients with angiographically significant narrowings in coronary arteries. These results are in accordance with the previous finding of increased total IgE (antibody involved in type I allergic reaction) post myocardial infarction. Allergic myocardial infarction (also known as Kounis syndrome) - a condition in which heart muscle ischemia results from allergic insult sometimes even in the absence of permanent coronary artery lesions - is another hint supporting the hypothesis of possible interaction between allergy and cardiovascular diseases.

Despite relatively many reports studying the association at molecular, in vitro and clinical level, the research investigating the problem as a whole, connecting laboratory data with clinical picture, is scarce. Our research aims at providing epidemiological evidence on the prevalence of allergy and atopy as well as serum allergy markers profile in subjects with coronary artery disease.

Our study is dedicated to post-coronary angiography subjects willing to express informed consent for study participation.

Coronarography has been chosen as a verification tool for several reasons:

* it gives more accurate diagnosis of clinically relevant coronary narrowings than basic ECG, ECG exercise test or coronary angioCT
* it enables the distinction between typical angina pectoris and Prinzmetal's angina
* it has become a common procedure in Poland giving a relatively large and diverse cohort of patients undergoing the procedure whom we could address

Conditions

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Coronary Artery Disease Allergy Asthma

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients with negative coronarography.

Subjects who underwent coronary angiography and were classified as having no critical lesions in coronary arteries (a lesion of up to 50% of artery lumen is accepted as non-critical).

No interventions assigned to this group

Patients with positive coronarography

Subjects who underwent coronary angiography and were classified as having critical lesions in coronary arteries (over 50% narrowing of artery lumen).

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* available result of coronary angiography
* able to express written informed consent for study participation
* able to perform forced expiratory manoeuvre for spirometry

Exclusion Criteria

* ongoing infection
* exacerbation of chronic disorder (e.g. asthma, COPD, CVD, chronic kidney disease, neoplasm\<10 years from complete remission)
Minimum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Science and Higher Education, Poland

OTHER_GOV

Sponsor Role collaborator

European Union

OTHER

Sponsor Role collaborator

Medical University of Lodz

OTHER

Sponsor Role lead

Responsible Party

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Piotr Kuna, MD, PhD

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Piotr Kuna, Prof.

Role: PRINCIPAL_INVESTIGATOR

Medical University of Lodz

Locations

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Clinic of Internal Medicine, Asthma and Allergy

Lodz, , Poland

Site Status

Countries

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Poland

References

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Szczeklik A, Dropinski J, Gora PF. Serum immunoglobulin E and sudden cardiac arrest during myocardial infarction. Coron Artery Dis. 1993 Nov;4(11):1029-32. doi: 10.1097/00019501-199311000-00012.

Reference Type BACKGROUND
PMID: 8173709 (View on PubMed)

Szczeklik A, Milner PC, Birch J, Watkins J, Martin JF. Prolonged bleeding time, reduced platelet aggregation, altered PAF-acether sensitivity and increased platelet mass are a trait of asthma and hay fever. Thromb Haemost. 1986 Dec 15;56(3):283-7.

Reference Type BACKGROUND
PMID: 3563961 (View on PubMed)

Szczeklik A, Jawien J. Possible role of IgE in acute-phase response. Allergy. 1997 Nov;52(11):1149-50. doi: 10.1111/j.1398-9995.1997.tb00196.x. No abstract available.

Reference Type BACKGROUND
PMID: 9404576 (View on PubMed)

Kauhanen P, Kovanen PT, Reunala T, Lassila R. Effects of skin mast cells on bleeding time and coagulation activation at the site of platelet plug formation. Thromb Haemost. 1998 Apr;79(4):843-7.

Reference Type BACKGROUND
PMID: 9569202 (View on PubMed)

Wang J, Cheng X, Xiang MX, Alanne-Kinnunen M, Wang JA, Chen H, He A, Sun X, Lin Y, Tang TT, Tu X, Sjoberg S, Sukhova GK, Liao YH, Conrad DH, Yu L, Kawakami T, Kovanen PT, Libby P, Shi GP. IgE stimulates human and mouse arterial cell apoptosis and cytokine expression and promotes atherogenesis in Apoe-/- mice. J Clin Invest. 2011 Sep;121(9):3564-77. doi: 10.1172/JCI46028. Epub 2011 Aug 8.

Reference Type BACKGROUND
PMID: 21821913 (View on PubMed)

Heikkila HM, Trosien J, Metso J, Jauhiainen M, Pentikainen MO, Kovanen PT, Lindstedt KA. Mast cells promote atherosclerosis by inducing both an atherogenic lipid profile and vascular inflammation. J Cell Biochem. 2010 Feb 15;109(3):615-23. doi: 10.1002/jcb.22443.

Reference Type BACKGROUND
PMID: 20024959 (View on PubMed)

Kovanen PT. Mast cells in atherogenesis: actions and reactions. Curr Atheroscler Rep. 2009 May;11(3):214-9. doi: 10.1007/s11883-009-0033-7.

Reference Type BACKGROUND
PMID: 19361353 (View on PubMed)

Lindstedt KA, Kovanen PT. Mast cells in vulnerable coronary plaques: potential mechanisms linking mast cell activation to plaque erosion and rupture. Curr Opin Lipidol. 2004 Oct;15(5):567-73. doi: 10.1097/00041433-200410000-00011.

Reference Type BACKGROUND
PMID: 15361793 (View on PubMed)

Kovanen PT. Mast cells: multipotent local effector cells in atherothrombosis. Immunol Rev. 2007 Jun;217:105-22. doi: 10.1111/j.1600-065X.2007.00515.x.

Reference Type BACKGROUND
PMID: 17498055 (View on PubMed)

Kwon JS, Kim YS, Cho AS, Cho HH, Kim JS, Hong MH, Jeong SY, Jeong MH, Cho JG, Park JC, Kang JC, Ahn Y. The novel role of mast cells in the microenvironment of acute myocardial infarction. J Mol Cell Cardiol. 2011 May;50(5):814-25. doi: 10.1016/j.yjmcc.2011.01.019. Epub 2011 Feb 3.

Reference Type BACKGROUND
PMID: 21295578 (View on PubMed)

Deliargyris EN, Upadhya B, Sane DC, Dehmer GJ, Pye J, Smith SC Jr, Boucher WS, Theoharides TC. Mast cell tryptase: a new biomarker in patients with stable coronary artery disease. Atherosclerosis. 2005 Feb;178(2):381-6. doi: 10.1016/j.atherosclerosis.2004.09.008.

Reference Type BACKGROUND
PMID: 15694948 (View on PubMed)

Kervinen H, Kaartinen M, Makynen H, Palosuo T, Manttari M, Kovanen PT. Serum tryptase levels in acute coronary syndromes. Int J Cardiol. 2005 Sep 30;104(2):138-43. doi: 10.1016/j.ijcard.2004.10.023.

Reference Type BACKGROUND
PMID: 16168805 (View on PubMed)

Other Identifiers

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NN402374938

Identifier Type: -

Identifier Source: org_study_id

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